Journal : Photographic review of medicine & surgery ; vol. 1., no. 4.
Philadelphia : J. B. Lippincott & Co., 1870-71.
Description : pp. 39-41,  pl. ; ill.: 2 photo. ; 24 cm.
Photograph : 2 mounted albumens.
Subject : Lymphatic system — Filariasis.
THE accompanying photographs are those of Allen Stockwell, a resident of Poland, Chautauqua County, N.Y. He was born, where he now resides, April 22, 1838. His ancestors, both paternal and maternal, were hardy, rugged people, and his brothers and sisters — he being the eldest of seven children — have a like firm and healthy constitution. His own health has always been good. After he became old enough to labor, he worked in the lumber woods most of his time, making several trips down the Alleghany and Ohio Rivers each year. Like all other lumbermen, he worked hard, was much in the water, and drank a fair allowance of whisky ; yet his health was good all this time, and he had no febrile symptoms. His leg commenced to enlarge in the spring of 1858, he being then twenty years of age. At that time he was on a raft lying in the Ohio River, at Cincinnati. The weather was warm, and he was in the water a good deal, removing lumber to the shore, yet he experienced no unusual symptoms, except the slow but gradual enlargement of his leg.
All the text-books that I have consulted upon this subject, claim that there is more or less fever connected with the commencement of this disease; but the patient denies ever having had any fever whatever in connection with the enlargement. He claims that his appetite was good, and that he always felt perfectly well. In the fall of 1859 he was for three or four weeks under the care of Prof. Frank H. Hamilton, then of Buffalo, who succeeded in the reduction of the enlarged limb to about its normal size. Being uneasy, and tiring of hospital discipline, the patient went away, discontinuing treatment.
Since that time his leg has gradually and constantly enlarged, except for a period of four or five weeks, which occurred about six years ago, when he had typhoid fever. During the period of this illness his leg nearly recovered its natural size ; but, upon convalescing, it again commenced enlarging, and soon the under and back side of the enlargement above the knee began to discharge an offensive fluid. This discharge has been constant since, though of a variable amount. The skin of the upper part of the thigh is thickened, but is not scaly or of darker color than natural, but from above downwards the skin grows harder, scaly, and of a darker color, so that the integument of the foot very closely resembles that of the elephant. The limb now measures — Dec. I, 1870 — around the greatest enlargement, fifty-seven inches ; in the fissure just below it, twenty-nine inches; just below the fissure, thirty-six inches; and midway between the knee and ankle, thirty inches. Measurements around the same points, twenty-two months before, gave, respectively, fifty-one, twenty-eight, thirty-three, and twenty-eight inches. The measurement around the instep is twenty-two inches, around the foot, sixteen. The nates are of natural size, so also the right testicle, but the scrotum is fourteen inches in circumference, the enlargement being mostly confined to the left testicle. His weight was formerly from one hundred and thirty-five to one hundred and forty pounds, but he now weighs three hundred pounds. Although his limb is a great burden to him, his health and strength are good, and he makes his usual trips on the rafts, being still considered a good raftsman. During the remainder of the year he works but little, owing to the difficulty he experiences in walking.
I have been acquainted with him for the past four years, but I have never treated him with a view to produce a reduction of the enlargement, not considering it possible.
Doubtless no more perfect specimen of this disease is to be found anywhere, the case under consideration being one of unusual development.